Aging leads to the development of fine line and wrinkles. Many cosmetic aids have been introduced to treat different kinds of signs of aging, but perioral lines continue to be a challenge, often needing invasive treatments.

Understanding Perioral Lines

Perioral lines or perioral wrinkles surface around the mouth without a definite pattern. In some people, perioral lines are more pronounced above the upper lip, while in some they are more marked around the edge of the lips, along the lower jaw. Perioral lines can be as deep as exaggerated facial frowning that is seen along the forehead of some people. Perioral lines can be present in the form of multiple, small lines or a few but deep creases.

Being concentrated around the mouth, their visibility is enhanced every time the mouth is moved in the most minimal of manner. The smallest of facial expression, conversation or physical exertion tends to highlight perioral lines. These lines are also called smoker’s lines or vertical lines. This is mainly because of their concentration around the lips that is often more marked among chronic smokers.

Typical facial areas that have perioral lines are:

  • Nasolabial folds/grooves (as lines or grooves extending vertically from the base of nose to upper lip)
  • Corner of mouth (including the more extensive, smile lines)
  • Upper chin (also called marionette lines)
  • Oral Commissures (small grooves found along the jaw)
  • Lateral groove of mandible (middle portion of lower jaw)

Cause of Perioral Lines

Perioral lines are formed due to the natural loss of skin’s volume and elasticity that is associated with aging. Thus, perioral lines are often regarded as the result of involuntary or progressive degeneration of skin. Aging causes gradual erosion of the lipids or fat under the skin that is responsible for sustaining the stretched nature of facial skin, along with assisting the action of facial muscles.

The formation of perioral lines proceeds more aggressively if the skin is exposed the sun without seeking proper protection, and due to lifestyle habits like smoking. Sun damage, along with low level of essential nutrients and hydration, makes the facial skin age faster.

Some people are genetically predisposed to developing creasing of skin around their mouth that mimics perioral lines, but are actually skin folds induced by facial structure. However, this form of skin creasing makes the skin more vulnerable to developing perioral lines as the individual ages.

Apart from aging, the formation of perioral lines is often assisted by other factors such as:

  • Loss of facial skin volume due to chronic diseases
  • Use of ill-fitting dental structures for a long time
  • Abnormally thin facial skin that is more prone to creasing

Facial Muscles Associated with Perioral Lines

Some muscles contribute more towards the formation of perioral lines as the individual ages. This includes the procerus muscle that is responsible for the horizontal creasing that originates around the bridge of nose and extends in the form of nasolabial perioral lines.

Depressor Anguli Oris muscle is responsible for stretching the skin at the corner of the mouth. Loss of elasticity in these muscle fibers causes drooping of skin and formation of typical perioral lines, called marionette folds. These folds lend the face a typical, depressed look.

Aged platysma muscles are responsible for the depression-like wrinkles found along the lower lip that often extend into the chin and the upper neck region. Platysma is heavily contracted during emotional expressions related with feeling of anger or anxiety.

Perioral lines are also formed due to the repeated movement of the orbicularis oris muscle that is found along the opening (sphincter) of the mouth. These muscles are affected by excessive smoking.